Quick answers
- Where is Tsali Care Center?
- 267 Tsali Care Way, Cherokee, NC 28719, in Swain County, North Carolina.
- What is the phone number of Tsali Care Center?
- (828) 497-5048, as listed by Medicare (CMS).
- What is the Medicare star rating of Tsali Care Center?
- Medicare overall rating: 1 out of 5 stars (CMS data updated 2026-10-01).
- Has Tsali Care Center been fined?
- Medicare lists 4 fines totaling $157,555 and 1 payment denial.
- What did inspectors find at Tsali Care Center?
- In its last three inspection cycles (July 13, 2023 to August 6, 2026), Medicare lists 79 health citations; the most serious was level G. 4 were level G or higher (actual harm or immediate jeopardy). See the list below (CMS data updated 2026-10-01).
Medicare ratings, explained
Star ratings are one piece of information. Visit, ask questions and talk with your doctor about what matters for your care.
Inspections, fines and staffing
In its last three inspection cycles (July 13, 2023 to August 6, 2026), Tsali Care Center had 79 health citations; the most serious was level G (actual harm to residents). 4 of them were level G or higher (actual harm or immediate jeopardy). It was fined $157,555 in total (4 fines, the latest on July 31, 2025) and had 1 Medicare payment denial. Nurse staffing is 5.86 hours per resident per day; the North Carolina average is 3.87 and the national average is 3.90.
Source: Medicare (CMS) Provider Data Catalog, data updated October 1, 2026, retrieved November 13, 2026.
Inspection history: last three cycles
State inspectors visit about once a year and also investigate complaints. Each citation (deficiency) has a tag number and a letter, A to L. The letter shows how serious the problem was and how many residents it affected.
What the letters A to L mean
| Seriousness | Isolated (a few residents) | Pattern (some) | Widespread (many) |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm to residents | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Source: the scope and severity grid Medicare (CMS) uses for nursing home citations.
Most recent cycle: August 1, 2025 — 27 health citations
Inspections in this cycle: August 1, 2025 (standard health inspection); August 6, 2026 (complaint investigation).
Show 27 citations (levels A to F, no actual harm)
F0835 Level F
“Administer the facility in a manner that enables it to use its resources effectively and efficiently.”
F0867 Level F
“Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.”
F0552 Level E
“Ensure that residents are fully informed and understand their health status, care and treatments.”
F0554 Level E
“Allow residents to self-administer drugs if determined clinically appropriate.”
F0578 Level E
“Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.”
F0583 Level E
“Keep residents' personal and medical records private and confidential.”
F0585 Level E
“Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.”
F0761 Level E
“Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0883 Level E
“Develop and implement policies and procedures for flu and pneumonia vaccinations.”
F0628 Level D
“Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.”
F0550 Level D
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0558 Level D
“Reasonably accommodate the needs and preferences of each resident.”
F0605 Level D
“Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.”
F0636 Level D
“Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.”
F0644 Level D
“Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.”
F0645 Level D
“PASARR screening for Mental disorders or Intellectual Disabilities”
F0656 Level D
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0676 Level D
“Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0688 Level D
“Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.”
F0689 Level D
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0698 Level D
“Provide safe, appropriate dialysis care/services for a resident who requires such services.”
F0699 Level D
“Provide care or services that was trauma informed and/or culturally competent.”
F0791 Level D
“Provide or obtain dental services for each resident.”
Previous cycle: August 22, 2024 — 27 health citations
Inspections in this cycle: August 22, 2024 (standard health inspection); October 18, 2024 (complaint investigation); April 10, 2025 (complaint investigation); August 1, 2025 (complaint investigation).
F0689 Level G
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
actual harm to residents; isolated (a few residents) · Quality of Life and Care Deficiencies
F0697 Level G
“Provide safe, appropriate pain management for a resident who requires such services.”
actual harm to residents; isolated (a few residents) · Quality of Life and Care Deficiencies
Show 25 less serious citations (levels A to F)
F0804 Level F
“Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.”
F0582 Level F
“Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.”
F0838 Level F
“Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.”
F0908 Level F
“Keep all essential equipment working safely.”
F0565 Level E
“Honor the resident's right to organize and participate in resident/family groups in the facility.”
F0578 Level E
“Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.”
F0759 Level E
“Ensure medication error rates are not 5 percent or greater.”
F0563 Level D
“Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.”
F0622 Level D
“Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.”
F0657 Level D
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0686 Level D
“Provide appropriate pressure ulcer care and prevent new ulcers from developing.”
F0760 Level D
“Ensure that residents are free from significant medication errors.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
F0698 Level D
“Provide safe, appropriate dialysis care/services for a resident who requires such services.”
F0550 Level D
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0568 Level D
“Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.”
F0584 Level D
“Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.”
F0623 Level D
“Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.”
F0625 Level D
“Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.”
F0645 Level D
“PASARR screening for Mental disorders or Intellectual Disabilities”
F0657 Level D
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0726 Level D
“Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.”
F0755 Level D
“Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.”
F0761 Level D
“Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
Earlier cycle: July 13, 2023 — 25 health citations
Inspections in this cycle: July 13, 2023 (standard health inspection); October 13, 2023 (complaint investigation); April 17, 2024 (complaint investigation); July 31, 2024 (complaint investigation).
F0689 Level G
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
actual harm to residents; isolated (a few residents) · Quality of Life and Care Deficiencies
F0686 Level G
“Provide appropriate pressure ulcer care and prevent new ulcers from developing.”
actual harm to residents; isolated (a few residents) · Quality of Life and Care Deficiencies
Show 23 less serious citations (levels A to F)
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0557 Level E
“Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0658 Level E
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0867 Level E
“Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.”
F0558 Level E
“Reasonably accommodate the needs and preferences of each resident.”
F0565 Level E
“Honor the resident's right to organize and participate in resident/family groups in the facility.”
F0572 Level E
“Give residents a notice of rights, rules, services and charges.”
F0573 Level E
“Let each resident or the resident's legal representative access or purchase copies of all the resident's records.”
F0574 Level E
“The resident has the right to receive notices in a format and a language he or she understands.”
F0577 Level E
“Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.”
F0582 Level E
“Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.”
F0679 Level E
“Provide activities to meet all resident's needs.”
F0680 Level E
“Ensure the activities program is directed by a qualified professional.”
F0761 Level D
“Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.”
F0550 Level D
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0578 Level D
“Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.”
F0645 Level D
“PASARR screening for Mental disorders or Intellectual Disabilities”
F0656 Level D
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0695 Level D
“Provide safe and appropriate respiratory care for a resident when needed.”
F0740 Level D
“Ensure each resident must receive and the facility must provide necessary behavioral health care and services.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
Citation descriptions are Medicare’s official wording. “From a complaint” means the citation came from a complaint investigation instead of the regular yearly inspection.
Full inspection reports on Medicare Care Compare →
Fire safety citations (1)
K0353 Level D
“Inspect, test, and maintain automatic sprinkler systems.”
Fines and payment denials
Total fines over about the last three years: $157,555 (4 fines). A payment denial means Medicare stopped paying for new admissions for a time.
| Date | Penalty | Amount or length |
|---|---|---|
| July 31, 2025 | Fine | $11,047 |
| April 10, 2025 | Fine | $15,028 |
| July 31, 2024 | Fine | $12,542 |
| July 31, 2024 | Fine | $118,938 |
| July 31, 2024 | Payment denial | from August 29, 2024, 81 days |
Source: Medicare (CMS) Penalties file, data updated October 1, 2026.
Staffing
Hours of nursing care per resident per day, from the payroll records nursing homes send to Medicare, next to the state and national averages.
| Measure | This home | North Carolina | National |
|---|---|---|---|
| Registered nurse (RN) hours per resident per day | 1.19 | 0.62 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 0.56 | 0.88 | 0.86 |
| Nurse aide hours per resident per day | 4.10 | 2.37 | 2.35 |
| Total nurse staff hours per resident per day | 5.86 | 3.87 | 3.90 |
| Total nurse staff hours per resident per day on the weekend | 5.34 | 3.40 | 3.43 |
| RN hours per resident per day on the weekend | 0.88 | 0.41 | 0.48 |
| Nursing staff turnover (per year) | 49.2% | 48.7% | 45.3% |
| RN turnover (per year) | 26.3% | 45.7% | 42.5% |
| Administrators who left in the last year | 0.0 | 0.6 | 0.5 |
Source: Medicare (CMS) Provider Information and State US Averages, data updated October 1, 2026.
Owners and operator
Legal business name: Cherokee Indian Hospital Authority.
Owners and managers Medicare lists (1)
| Name | Role | Share | Since |
|---|---|---|---|
| Cherokee Indian Hospital Authority | Management company (operational or managerial control) | NOT APPLICABLE | January 1, 2002 |
Source: Medicare (CMS) Ownership file, data updated October 1, 2026. Only owners with an ownership interest and management companies are shown.
Compare with other nursing homes
Key facts
| Type | Nursing home |
|---|---|
| Certified beds | 100 |
| Average residents per day | 92.9 |
| Takes part in | Medicare and Medicaid |
| Ownership | Non-profit – corporation |
| Legal business name | Cherokee Indian Hospital Authority |
| First approved by Medicare/Medicaid | 1996-04-18 |
| Resident and family councils | Resident council |
| Sprinklers in all required areas | Yes |
| Changed ownership in the last 12 months | No |
| Address | 267 Tsali Care Way, Cherokee, NC 28719 |
| County | Swain County |
| State | North Carolina |
| Phone | (828) 497‑5048 |
| CMS Certification Number | 345475 |
| Corrections | Report an error or suggest an update → |
What to ask when you call or visit
A general checklist for any nursing home, not advice about this one. Medicare also publishes guides on medicare.gov.
- Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
- Can you see the latest state inspection report? Ask how any problems found were fixed.
- How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
- Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
- What therapy (physical, occupational, speech) is offered, and how many days a week?
- Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
- What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
- Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
- Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
- Visit more than once, including at a mealtime or in the evening, without an appointment.
Other nursing homes nearby
By straight-line distance (not driving distance).
- Mountain View of Bryson City8.1 mi · Bryson City, NC · 1 of 5 stars
- Vero Health & Rehab of Sylva9.9 mi · Sylva, NC · 1 of 5 stars
- Skyland Care Center9.9 mi · Sylva, NC · 4 of 5 stars
- Maggie Valley Health and Rehabilitation Center14 mi · Maggie Valley, NC · 2 of 5 stars
- Autumn Care of Waynesville19 mi · Waynesville, NC · 1 of 5 stars
Nearest hospital emergency rooms
- DLP Swain County Hospital LLC6.4 mi · Bryson City, NC · Critical Access Hospital
- Harris Regional Hospital10.0 mi · Sylva, NC · Acute Care Hospital
- Cherokee Indian Hospital Authority10 mi · Cherokee, NC · Acute Care Hospital
Sources
- Provider Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-01, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this provider
- Health Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Fire Safety Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Penalties — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Ownership — CMS, data updated 2026-10-01, retrieved 2026-11-13
- State US Averages — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Survey Summary — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Citation Code Look-up — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Inspection Dates — CMS, data updated 2026-10-01, retrieved 2026-11-13